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QP905  .L85  Pharmacologic  diagra 


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HARMACOLOGIC  DIAGRAMS. 

ILLUSTRATING  THE 

PHYSIOLOGIC  ACTION 
OF  THE  MOST  IMPORTANT  DRUGS, 

WITH  BLANK  DIAGRAMS 
FOR  PHYSIOLOGIC  OR  PHARMACOLOGIC  LABORATORY  NOTES. 


BY 

ELI    H.   LONG,   M.  D., 

PROFESSOR  OF  THERAPEUTICS,   UNIVERSITY  OF  BUFFALO. 


miKKALo: 
C.  K.  JAME80N, 

1  •'»  5     K  A  H  T     1 1  T  I  r  A     S  I-  K  F,  K  T 
I!M)1. 


u?-^ 


.^  PREFACE. 

CD 

■^  The  purpose  of  this  puhlicatioii  is  to  aid  tlie  student  in  a  very  needful 

direction — tliat  of  fixinji  in  liis  mind  the  essential,  distinctive  action  of  the 

"*"    most  important  internal  drugs.     Tlie   use  of  diagrams  necessitates  the  dis- 

^    regard  of  pure    tlieory.     Tlierefore  the  summary  of  physiologic  ett'ects  of 

^   each   drug  is  intended  to   include  only   demonstrated    facts  or  generally 

accepted   beliefs.     No   attempt  is  made   to  explain   tlie  methods   of  drug 

action,  but  ratlier  to  illustrate  and  briefly  state   tlie  fticts.     As  every  drug 

cannot   be    illustrated    in  this   way,  some    substances    of   importance   are 

necessarily  omitted. 

The  blank  pages  and   diagrams  in    the  latter  part  are  intended    for 
notes  in  either  physiologic  or  pharmacologic  laboratory  study. 


INDEX. 


Pagk 

Aconite 3 

Alcoliol 4-0 

Amyl  Nitrite 21 

Atropine (i-7 

Belladonna (>-7 

Bromides H 

Butyl-Chloral 15 

Caffeine 11 

Cathartics 12-13 

Chloral lo 

Chloralamide 15 

Chloroform 27 

Convallaria 19 

Coca 16-17 

Cocaine 16-17 

CJodeine 25 

Digitalis 19 

Ether 2(i 

Ergot 20 

Olonoin 21 


Page 

Heroine 25 

Homatropine 6 

Hyoscine 6 

Hyoscyamine 6 

Morphine 25 

Nitrites 21 

Nitroglycerin  . . . 21 

Nux  Vomica 23 

Opiun) 25 

Paraldehyd 15 

Scilla 19 

Sodium  Nitrite 21 

Strophaiithus 19 

Strychnine 23 

Sulphonal 15 


Theobromine 

Trional 

Tetronal 

Veratrine 

Veratrum  Viride. 


11 

15 

15 

3 

3 


General  Explanation  of  Diagrams. 

RED  {ilwavs  iiMlicMtfs  stiiimlMfioii,  or  inei-HHse  of  activity. 
BLUE  iihvavH  indicMtf'K  (lopi-H.s.sjoii,  or  (liiniiiiition  of  aotivity. 
STK.\n;irT    FiF.VKH  or    Lau(;k    Dot.s   indifnt*'   nerve  irritahilitv  or 
jictivity. 

Cn{VKi>  liiM'.s  iii(|i<-;i1«'  niiisclc  ii-iil  nliility  or  jic(i\i1  y. 
S.MArj.  Doth  iiidicjitc  o|;iii(|ii|;ip  oi-  sccictoi-v  activitv. 


ACONITE— Yeratrum  Yiride. 

[For  genoral  explanation  of  diagrams  see  page  one.] 


Vi:KA'I"li(:M     VIRFDE    and    VERATRINE    have    an 
action  wliicli  n^HemblcH  closfily  tliat  of  Aconite. 


ACONITE. 

The  tuber  of  A.  Xnpellus. 


riassified  as: 
Arterial  depressant. 
Cardiac  dei)re.ssant. 
XeiA'e  depressant. 
Antipyretic. 

•Sensory 
nerve  enclin 
■lepressecl 

Pliysiolog-ic 

action  : 

Nervoua  Si/sfrni. 
Brain.    No  influence  upon  cerebrnni. 
Medulla.    Stimulates   vagus   centre.      Prob- 
ably depresses  respiratory  centre. 
Spinal  cord.     Tntlnence  uncertain. 
Sensory    nerve    endings  are    depressed  after 
a  period  of  slight  stimulation. 
Muxc-nlar  Sifstem.    Causes  general  muscular  weakness. 
Circulation.     Lessens  force,  rapidity  and  pressure  of  tlje 
arterial  current. 
Heart.    A  direct  influence  upon  tlie  heart  is  uncertain, 
but  by  stimulation  of  inhibition  the  heart  is  siowed 
and  its  force  weakened— the  result  being  cardiac  de- 
pression.    (According  to  some  authorities  the  drug 
depresses  the  heart  nuiscle  and  its  motor  ganglia.) 
Capillary  area.     The  vaso-motor  influence  of  the  drug 

is  uncertain. 
Temperature  is  reduced. 

OFFK'IAIv    PItKPAUATIOXH. 

Extractum  Aconili Gm.  .000— .015 

I'Jxtracturn  Aeoniti  Fluidi..  Xim.  .0.'5  — .12 

'/•inrfiira  Ar.nnUi Gm.  .08  — ..".O         -.^  /  -5 


V<lviaP/«xHt. 


U  u-1-^ 


OFFICIAL    IMll':r»AllATI().\S. 

/'Jjctraf/nm  Verafri  Viridin  Flu'ulum Gm.  .()<>  — .30         ^     -,i      ,    / 

TincJnni    Vfratri    ViridiH Gi'i.   .12  —.00  7-  -^        "   "^ 

\Wntrina <'"'•   .002-.(X)6 


4  ALCOHOL. 

[For  general  explanation  of  diagrams  see  page  one. 

ALCOHOL. 

Used  eomnionly  in  the  form  of 
Whisli.v,  Brandy  or  Wine. 

Classified  as : 

Irritant.  Astringent. 

Antiseptic.         Stimulant. 
Narcotic.  Anpesthetic. 

PhysiolQgic  action  : 

To  summarize  the  phj'siologic  ef- 
fects of  alcohol  is  very  diflicult, 
owing  to  the  contradictory 
opinions  held  by  good  authori- 
ties. While  most  writers  agree 
that  the  full  effect  of  a  large 
dose  of  the  drug  is  that  of  a 
general  depressant,  there  is  no 
.  agreement  as  to  the  influence 
of  a  small  dose. 

Two  diagrtiin.s  are  liere  presented  : 

No.  1  represents  the  action  of  a  small  dose  as 
taught  by  those  who  hold  that  its  primary 
influence  includes  stimulation  of  tlie  eere- 
/    brum  and  of  the  heart. 

No.  2  shows  tlie  depressant 
action  of  a  jarg'e  dose  upon 
tlie  nervous  system,  cir- 
culation and  digestion. 
Many  observers  deny  the 

primary'stimulant  at-tion,  holding  that  the  drug  is  a 
depressant  from  the  first,  or  even  a  small  dose.  The 
excitement  of  intoxication  is  not  due  to  stimulation, 
but  to  depression  of  tlie  higii^T  controlling  centres. 

Local  action.  Irritant,  by  reason  of  its  affinity  for 
water.  When  applied  to  the  mucous  membrane  of  the 
digestive  tract  the  irritation  probably  induces  reflex 
stimulation,  which  may  account  in  part  for  the  pri- 
mary stim^ilaut  effect  attributed  to  the  drug. 

Digestion.  In  small  doses,  well  diluted,  alcohol  seems  to 
increase  gastric  secretion  and  motility,  while  stronger 
solutions.  (5%   or  more)  retard  the  digestive  process. 

As  a  food  the  position  of  alcohol  has  not  been  very 
definitely  determined.  A  small  part  only  can  he 
recovered  as  alcohol  from  the  fluids  of  excretion.  The 
greater  part  therefore  is  changed  into  other  iiroducts 
and  is  believed  thereby  to  contribute  some  energy  to 
the  body.  The  economy  to  the  system  of  its  use  may 
be  open  to  question,  as  it  does  not  seem  to  economize 
nitrogenous  waste. 

Metabolism.  Its  influence  upon  nutritive  changes  and 
upon  elimination  is  uncertain. 


V«W»cP(exH3. 


No.  I. 


ALCOHOL. 

[Foi-Konrial  explanation  of  diagrams  see  page  one 


Mi/»CP/«XH3, 


No.  2. 


6  BELLADONNA— Atropine. 

BELLADONNA. 

Leaves  and  root  of  Atropa  B.    The  alkaloid  Ati'opine  repi'esents  the  drug  fully. 

Classified  as : 

Cerebral  stimulant.  Deliriant  narcotic.  Mydriatic, 

Cardiac  stimulant.  Antispasmodic.  Antihidrotic. 

Physiologic  action  : 
In  general ''  atropine  acts  as  a  stimulant  to  tlie  central  nervous  system  and 
paralyzes  the  terminations  of  a  number  of  the  nerves,  more  especially  of 
those  that  supply  involuntary  nuiscle,  secretory  glands  and  the  lieart." 
[CusHNY.]     It  paralyzes  peripheral  inhibition.     It  decreases  the  secre- 
tions generally,  except  tlie  urine,  and  increases  the  body  temperature 
producing  a  condition  simulating  fever. 
Nervous  Si/stem. 
Brain.    Stimulates  cerebrum,  especially  in  its  motor  areas. 
Medulla.     Stimulates  respiratory  and  vaso-motor  centres. 
Spinal  cord.    Depresses  inliibitory  centres. 
Nerves. 
Sensory.    Depresses  sensory  nerve  endings. 
Motor.    Depresses  motor  nerves. 

Secretory.    Paralyzes  the  endings  of  man^-  of  the  secretory  nerves,  causing 
a  diminution  or  arrest  of  the  secretion,  hence  tliere  result  dryness  of  tlie 
mouth,  lessened  secretion  of  gastric  and  pancreatic  juices  aiid  of  milk. 
Tlie  sweat  glands  are  rendered  less  active. 
Vagus.    Paralyzes    the  inhibitory   terminations  of   the  vagus   within    the 
heart  and  the  secretory  terminations  within  the  digestive  system. 
Muscular  System.     Depresses  unstriped  muscle,  but  has  no  influence  upon 
voluntary  muscle.    Lessens  the  movements  of  stomach,  intestines,  blad- 
der,  uterus,  and  in  general  tlie  organs    containing  unstriped   muscle, 
except  the  arterial  walls.     [Cushny.] 
Eye.    Pupils  are  dilated  by  paral3'sis  of  terminals  of  the  motor  oculi  nerve 
in  tiie  iris,  with  possible  stimulation  of  the  sympathetic  terminals.     It 
paralyzes  accommodation.    Most  authorities  state  tliat  it  increases  intra- 
ocular pressure. 
Circulation.    Arterial   pressure  is   hicreased,  chiefly  by  central   vaso-motor 
stimulation. 
Heart.    Increases  pulse  rate  by  paralyzing  inhiliition  (peripheral  ends  of 
vagus.)      The  heart  muscle  or  its  accelerator   nerves   may   be   feebly 
stimulated. 
Capillary  area.    Arterioles  are  contracted. 
Resinration.    Stimulated  by  action  upon  respiratory  centre. 
Excretion.     Perspiration  is  lessened.    The  drug  is  excreted  rapidly  by  the 
kidneys,  but  its  influence  upon  their  activity  is  uncertain. 

CHIEF  OFFICIAL   PKEPAEATIONS. 

Extractum  Belladonnce  Folioimm  Alcoholicum.  . . .  .Gm.  .0075 —  .03 

Tinctura  Belladonnce  Foliorum Gm.  .80    — 2. 

Extractum  Belladonnce  Radicis  Fluidum Gm.  .06    —  .20 

Atropince  Sulphas Gm.  .0005 —  .001 

Alkaloids  having  similar  action  : 
HYOSCYAMINE  and  HYOSCINE— From  Hyoscyamus.    Less  stimulating 
to  central  nervous  system.    More  hypnotic  and  sedative. 

Hyoscyamince  Suljjhas Gm.  .001 — .002     Hyoscince  Hydrobromas, 

HyosoyamincB  Ilyclrobromas.  .Qm.  .001 — .002  Gm.   .0004 — .001 

HOMATROPINE,  as  a  mydriatic,  produces  a  more  rapid   and   more    tran- 
sient dilation  of  the  pupil  than  does  atropine.      Used  locally. 


BELLADONNA- Atropine. 

[K..r  geiioral  explanation  of  dia-ranis  soo  page  one. 


li'ss  aotivp — 

Motor  nervfs 
:iiul  sonsory 
MtTve  enrtinti 
.t^'prpssfrt. 


VcUiePUxMS. 


\ 


BROMIDES. 
[For  sceneral  explanation  of  diagrams  see  page  one.] 


POTASSIUM 

BROMIDE. 

Classified  as: 

Cerebral  depressant. 

Nerve  depressant. 

Anti.^pasniodiac. 

Anaphrodisiac. 

Sensory 
nerve  cudin 
di'pressed 

Pliysiolog'ic  action  : 
The  depressant   effect  is  due  in  jiart  to  the 
potassium  base  wliicli  is  especially  de- 
pressant to  the  heart. 
Nervous  syntem. 

Brain.     Depresses  tlie  cerebral  cortex,  and 
especially  tlie  motor  areas. 

Medulla.  Depresses  the  respiratory  centre  slightly, 
.slowing  the  respiration. 

Spinal  cord.  Lessens  reflex  irritability,  probably  mainly 
through  a  depression  of  the  sensory  portion  of  the 
cord  and  the  peripheral  terminals  of  the  sensory 
nerves. 

Sensory  nerve  endings  are  depressed,  causing  a  slight  de- 
gree of  anjesthesia  in  some  regions. 

Sexual  function  is  depressed. 

Ch'onJnt'Km.     Arterial  pressure  lowered  somewhat. 
Heart.     l)('|»re.«ses  the  heart  sliglitly. 
Capillary  area.     Full  do>es  cause  vaso-motor  relaxation. 

Eliminfidoii.  The  drug  is  rajiidly  absorbed  from  tlie 
stomach,  but  is  eliminatedslowly.  It  may  be  found 
in  the  several  excretions  but  chiefly  in  the  urine. 

PotftHHii.  liromidum (Jm.  ..'')0 — 4. 

S'odii  lironiiduni (Jm.  .30 — 4. 

Lfss  irritating  and  rather  leKS  depressing. 

Ammoriii  liroinUliim (jin.  ..'SO — 2. 

[,<'asi  di-presKing  owing  to  tiio  arnmonlnni  base. 

LUhii  lirmnUhnn Om.   ..SO— 2. 

Stnmtii  liromiihiiii (Jm.   .I'O— 2. 


CAFFEINE— Theobromine. 

[For  general  expliination  of  diagrams  see  page  one.] 

CAFFEINE. 

An  Alkaloid  existing  in  coffee,  tea, 
guarana  and  cola  nut. 

Classified  as : 
Cerebral  stimulant. 
Cardiac  stimulant. 
Diuretic. 

Physiologic  action : 

Nervous  System. 

Cerebrum.  Stimulates  cor- 
tex, increasing  the  ac- 
tivity of  psycliic  func- 
tions. 

Medulla.  Stimulates  respi- 
ratory centre  and  vaso- 
motor centre.  Vasus 
centre  may  be  stimu- 
lated but  tlie  effect  con- 
cealed by  the  direct  ef- 
fect upon  the  heart. 

Muanular  Sijstem.     Irritability 
mu.scle  tissue  increased. 

Circulation.  Arterial  pressure  increased  by  vaso-motor 
activity. 
Heart.  Stimulates  heart  nuiscle,  producin<<  accelera- 
tion of  pulse. 
Capillary  area.  Contracts  arterioles  by  stinuilation  of 
vaso-motor  centre  in  the  medulla  and  probably  also 
by  direct  action  upon  the  constrictor  fibres  in  the 
vessel  walls. 

Ernrefion. 
Kidneys.  Stimulates  excretory  function,  botli  of  the 
glomeruli  and  the  renal  epithelium,  causing  increase 
of  water  and  of  solids,  the  increase  of  water  being- 
more  marked.  The  diuretic  effect  may  be  prevented 
by  the  vaso-motor  action. 


11 


OFFICIAL    PRRPAIIATIONR  : 

daffeinfi Gm.     .00—     ..SO 

(UijffAmi  ditrata Gm.     .12 —     .r>0 

(Uijfe'nia  difrfita  EfferveHceriH Gm.  4.     — 15. 


and   working    power    of 


Wv  JC  PfcXHS. 


Throttromint:  (from  Theobroma  cacao  and  from  (Juarana)  has  an  action  upon 
the  circulation  Kimllar  to  that  of  ('afTeine,  but  is  superior  as  a  diuretic 
and  lesH  stimulating  to  the  cerebrum. 


12  CATHARTICS. 

[For  genei'al  explanation  of  diagrams  see  page  one.] 


These  diagrams  are  intended  to  show  tlie 
different  ways  in  which  cathartics  may  act. 

•It  is  not  possible  to  classify  strictly,  as  the 
action  of  some  is  too  extensive  to  be  limited  to 
one  group  or  illustrated  by  a  single  diagram. 

The  numbers  indicate  the  diagrams  that 
represent  what  is  believed  to  be  the  most 
prominent  action  in  case  of  each  drug,  with- 
out intending  to  show  the  complete  action  in 
every  instance. 

Group  A.     LAXATIVES. 

Fruits.    (1) 

Sugar.  /  '} 

Sulphur. 

Purges  in  small  doses. 

Glycerin  (by  enema.)     (2) 

Group  B.    PURGES. 

Aloe.     (1) 
Mercurials.     (4) 
Oleum  liicini.     (4) 
miamnnsFrangula.     (Ij 
Ri)amnus  Pursliiana.     (1) 
Rheum.     (1) 
Magnesia. 
Senna.     (1)  (4) 

Group  C.    HYDRAGOGUES. 

iSalinea. 

Magnesii  Citras. 
Magnesii  Sulphas. 
Potassii  Bitartras. 
Potassii  et  Sodii  Tartras.(3 
Sodii  Phosphas.     (3) 
Sodii  Sulphas.     (3) 


(3) 

Elaterinum.  (4 

(3) 

Jalapa.  (4) 

(3) 

Senna.     (1)(4) 

Group  D.    DRASTICS 

. 

Coloc3Mithis.     (5) 

Oleum  Tiglii. 

(5) 

Elaterinum.     (4) 

Podophyllum. 

(5) 

Jalapa.     (4) 

Scammonium. 

{^) 

Caml)ogia.     (5) 

CATHARTICS.  13 

[For  general  expliiiiation  of  diasranis  see  page  one.J 

The  luitunil  provision  for  intestinal  evacua- 
tion includes  three  factors  : 

First.  A  certain  amount  of  indigestible 
matter  in  tlie  food. 

Second.  Peristaltic  motion  from  the  stonuicii 
downward. 

Third.  A  certain  degree  of  fluiditj'  of  con- 
tents, ^z^:^,^^.^^^  , 

A  deerefise  of  any  one  factor  tends  to  consti- 
pation, while  an  increase  tends  to  diarrhoea. 

Cathartics  act  by  intluencing  these  several 
factors. 

Laxative  foods  act  by  reason  of  their  in- 
digestible residue.  Almost  anj'  cathartic  may 
have  simply  a  laxative  efTect  when  used  in 
small  doses. 

Purges,  by  their  irritating  action,  stimulate 
peristalsis,  the  milder  ones  acting  mainly  upon 
the  large  intestine  (1).  Some,  in  large  doses, 
approach  drastics  in  severity  of  action  (5). 
The  absence  of  bile  diminishes  the  activity  of 
podophyllum,  jalapa,  rheum,  senna  and  scam- 
monium. 

Ilijdragogues  act  in  two  ways  : 

The  less  irritating  salines  cause  a  marked 
increase  of  fluid  by  determining  a  flow  of 
serum  from  the  l)lood  into  the  intestine  (3).  A 
low  blood  pressure  diminishes  their  activity. 

The  more  irritating  hydragogues  stimulate 
very  promptly  peristalsis  of  the  small  intes- 
tine, witii  the  result  that  the  fluid  contents  is 
hurried  onward  and  absorption  lessened  (4). 
Secretion  also  may  be  increased.  Copious 
licpiid  stools  result.  . 

/.(/•as/ics  stimulate  powerfully  the  peristaltic 
movement  of  tlie  wliole  tract  (5)  causing 
prompt,  frecjuent  stools  witii  severe  griping. 
In  large  doses  tiiey  act  as  irritant  poisons  and 
may  cause  contractions  in  the  gravid  uterus. 

(Jliolfigogurs  favor  the  flow  of  bile  into  the 
duodenum,  proltably  Ihrough  the  increased 
Ix-ristalsiH.  The  influence  of  cathartics  upon 
the  function  of  the  liver  seems  uncertain  and 
indin-ct. 


CHLORAL. 


15 


IKor  gonoial  explanation  of  diaj^i'anis  see  page  one.] 

CHLORAL. 

(Ch'.oral  Hydrate.)    Giii.  .30—1.30 

Classified  ns: 
Hypnotic. 
Narcotic. 

8piiml  depressant. 
Cardiac  depressant. 

Physiologic  action : 

Locally  applied  it  is  some- 
what irritant.     Internally  it 
resembles      chloroform      in 
action  except  tliat   it  is  not 
anaesthetic  in  safe  doses. 
Nervous  Sjfstem. 
Brain.  Depresses  cerebrnm. 
Induces  sleep,  but  does 
not  relieve  pain. 
Medulla.     Depresses   respi- 
latory    and    vaso-motor 
centres. 
Spinal  cord.     Depre.sses  re- 
flex centres. 
Mnncular  System.     Causes  general   muscular  weakness. 
Probal)Iy  depresses   muscular  coats  of  the  arterioles 
by  direct  action. 
Cirrnfafioii.     Reduces  arterial  pressure  in  marked  degree. 
Heart.    Depresses   the  cardiac  muscle,  causing  slower 

and  weaker  action. 
Capillary  area.     Dilates    arterioles  by  depressing    vaso- 
motor centre,  and  probably  also  by  direct  depressant 
action  upon  the  muscular  coats  of  the  vessels. 
Henpiration.     Depresses  respiratory  center. 
Tfrnpcffiture.     Reduced  by  full  doses. 

MtidhoVixm.  Destruction  of  proteids  is  increased  with  less 
perfect  oxidation.  With  prolonged  administration 
fatty  degeneration  of  various  organs  may  occur. 


?16%VIS. 


I>ni<is  juivino-  similar  action  : 

I'.rrVL-CHLOR.^L    HVDR.\TK.       Very     similar    to 
ehloral  in  action.  Gm.  ..']() — 1. 

I'.VkALDKH  VDl'.M.     Less    certain    and    less    i)leasant 
than  cliloral.  Cc.  L— 4. 

(  HLOKA  F..\.MIDK.     Is  less   depressant  to  the  circula- 
tion i»nt  less  certain  in  i(s  hypnotic  cirect.     (i!m.  \. — W. 

SrLI'H()NAI>,  'i'llIONAL  and  TETHONAL.  Safer  than  chloral,  but 
slower  in  action.  Trional  is  n)ore  soluble  than  sulpiional,  therefore 
usually  i)referred.     Dose  of  each (Jm.   I  .—2. 


16 


COCA— Cocaine. 

[For  general  explanation  of  diagrams  see  page  one. 


COCA. 

The  leaves  of  Erythroxylon  Coca. 
The  alkaloid  Cocaine  fully  represents  the  drug. 

Classified  as : 

Cerebral  stimulant. 

Mydriatic. 

Local  ansesthetic. 

General  j^rotoplasmic  poison. 

Physiologic  action  : 

The  drug  produces  flrst.a  descend- 
ing stimulation  of  the  central  nerv- 
ous system,  followed  by  a     sensory 
descending  depression  if  a     h";!"T.^,'.^"'^i''"^ 

o        i  aepressou 

large  dose  has  been  taken. 
The  succession  may  be  ir- 
regular, so  that  a  case  of  cocaine 
poisoning  may  sliow  mixed  symp- 
toms of  stimulation  and  depression. 
The  two  diagrams  presentedshow 
the  stimulant  and  depressant  ef- 
fects respectively. 


when  l()caU\ 

I M. lied- 


Diagram  I.  "^-^^^^^ 

Stomach.     The  local  eflfect  is  to  benumb  the  sensory  nerve  endings 

in  the  stomach. 
Nervous  Si/stem. 

Brain.    Stimulates  the  cerebral  cortex. 
Medulla.    Stimulates  respiratory  and  vaso-motor  centres. 
Spinal  cord.     Stimulates  reflex  centres. 

Sensory  nerve  endings  are  always  depressed  when  drug  is  applied 
locally. 
Muscular  System.     Increases  irritability   and   working  power   of 

voluntary  muscles. 
Eye.     Dilates  pupil  by  stimulating  dilator  nerves. 
Circulation.     Arterial  pressure  is  increased. 
Heart.    Action  accelerated  either  by  direct  stimulation  of  heart 

muscle  or  of  the  accelerator  nerves. 
Capillary  area.    Contracts  arterioles  by  stimulation  of  vaso-motor 
centre  in  the  medulla. 
Respiration.    Rate  increased  by  stimulation  of  respiratory  centre. 
Elimination.     Cocaine  has   been   detected  in   the  urine,   but   its 
influence  upon  the  kidneys  is  variable  and  uncertain,  there- 
fore probablj'  indirect. 


WvieP(exH3. 


COCA— Cocaine. 

[For  trencral  exi)lanation  of  diaurramsscc  pago  one.] 


17 


Diagram  2. 

Tlie  poisonous  effects  of  Coca,  or  the 
secondary  elfects  of  a  large  dose,  are  de- 
pressant, following  quite  definitely  the 
lines  of  previous  stimulation.  /  .i- 

NervouH  Sfjstern. 

Brain.    Cerebral   functions    are    de- ^ 
pressed,  frequently  with  the  pro-''^ 
duction    of  narcosis    or    convul- 
sions. 

Medulla.  Depresses  respiratory  cen- 
tre and  prohaltly  vaso-motor  cen- 
tre. 

Depresses    reflex    cen-Ji>t». 

Arterial      pressure      is 


Spinal  cord. 

tres.  -" — 


Circulation. 

lessened. 
Heart.    Depressed   by   direct  action  %^^ 

of  the  drug.  .     ,  .    ^•.•'*-*^ 

Capillary  area.       Arterioles    relaxed,  j,^ 

probably    through     paralysis     oTpf^ 

vasomotor  centre. 

Reapiration.     Depresses  tlie  respira-,^ 
tory  functions    by   lessening   thcj 
irritability   of    the  centre   in    thf^  " 
medulla. 


In  general,  the  depressant  action  is 
that  of  a  general  protoi>lasniic  poison, 
the  commonest  instance  of  wliich  is  its 
paralyzant  influence  upon  nerve  tissue 
when  locally  applied. 


h'^^f-^ 


OFFICIAL  PUEPAltATIONS: 

Ext7-achim  CnccR  Fluubtm, 

Gm.  1.     —8 
('nr.nirKf  Jfi/ih-ocfiloran. .  Aim.    .01 —  .0.'{ 

|Kor  local  ana'sthetic  purposes  the 
alkaloid  Cocaine  is  employed  in  from 
I  %  to  i'/,  solution  1 


DIGITALIS— Strophanthus. 

[For  general  explanation  of  diagrams  see  page  one.] 

DIBITALIS. 

The  leaves  of  D.  Purpurea  of  the 
second  year's  growth. 

Note.— The  description  below  is 
of  the  action  of  the  drug  or  of  pre- 
parations fully  representing  it. 

Classified  as: 

Cardiac  stiuiulant. 
Cardiac  tonic. 
Vaso-co  11  stricter. 
Diuretic. 

Pliysioloo'ic  action : 
Stomach.     Absorbed  slowly. 
Irritant  in  large  doses  or 
when  long  continued. 
Nervous  st/sfon. 

Brain.     Xo   influence  upon 

the  cereltruni. 
Medulla.    Stimulates  vaso- 
motor and  vaguscentres. 
Afuscular system.  Stimulates 

.^irectly  the  constrictor  fibres  of  the  arterioles. 
Circulation.    Gives  greater  force  and  rapidity  to  arterial 
current,  witli  higher  blood  pressure. 
Heart.    Stimulates     the    inhibitory    influence     (vagus, 
center  and    ])eriphery),  which  slows   the   heart  and 
tends  toward    relaxation.     Stimulates    the    cardiac 
muscle  and  contained  ganglia,   giving  greater  force 
to  tlie  contractions. 
Capillary  area.    Arterioles  contracted  botii  by  direct  local 
action  and    by  stimniiition    of  vaso-motor  centre  in 
medulla. 
/'J.ifrrfion. 
Kidneys.     Direct  action  upon  renal  epithelium  is  uncer- 
tain.    The  urine  is  increased,  but  mainly  thiougii  in- 
fluence of  higher  arterial  pressure. 


19 


OFFICIAL    I»REPARATIO\8 

[Hf/italiH (Jin. 

Hitracfum  Difjilalis (im. 

I-'jlra.fliini  Dif/ilaliH  Fliiidiirn.  .  .  .(>m. 

I II I'll. ■ill III  hiijilaliH (Jm. 

'riiu-tiira  I)i(jil<diH (im. 


.0:;  —     .20 
.01.5—     .00 
.08  —     .20 
4.       —15. 
.30  —  -2. 


)VlvieP/«xt«3. 


HTUOPHANTHUS  has  an  action  similar  to  (hat  of  Digi- 
talis, except  that  its  vaso-coiistrictor  influence  is  less. 
Ovvu'iM.  i'iti:i>Al{ATFo.v:    Tinctura  Slrophanthi.  Alim.  .12— .00. 

CONVALI>AIUA  and  SCILL.\  mIso  have  an  action    in  general  similar  to 
that  of  Dit^ilaiis. 


20 


ERGOT. 
[For  general  explanation  of  diagrams  see  page  one. 


ERBOT. 

A  fungus  replacing  the  grain  of  rye. 


Note.— The  description  helow  i.s  of 
the  action  of  the  whole  drug  or  of 
preparations  fully  representing  it. 


Classified  as : 
Oxytocic. 
Vaso-coiist  victor. 
Haemostatic. 

Physioloo'ic  action  : 
Digestive  tract. 

It  is  believed  to  stimulate 
gastric  motility  and  in- 
testinal peristalsis. 
NervouH  .si/stem. 

Brain.     Not  affected. 

Medulla.    Stimnlates    vaso- 
motor centre. 

Spinal  cord.      Stimulates 
centre    for   uterine  con- 
traction in  lower  part  of 
cord. 
Muscular  sijstem. 

Stimulates  uustriped  mus- 
cle,— noted  especially  in 
the  arterioles  and  gravid 
uterus.  May  cause 
spasm  of  s])hincter  vesi- 
cae. 
Circulation.  Arterial  pres- 
sure is  increased. 

Heart.     May  be  slowed,  but 
influence  not  definite. 

Capillary  area.  Arterioles 
contracted,  cliiefly  by 
central  vaso- motor 
stimulation. 
Uterus.  Stimulates  uter- 
ine contractions,  mainly 
by  Influencing  centre  in 
lower  part  of  si)inal  cord. 


On-^KIAL  PREPARATIONS  : 

Extractum  Ergotce Gm.     .30—  1. 

Ectractum  Ergotre  Fluidum Gm.  2.     —  4. 

Vinnm  Ergotre Gm.  4.     —15. 


ty  vie  P(exn3. 


NITRITES. 
fFor  giMieral  oxplaiiation  of  diagrams  see  page  one.] 


21 


Amyl  Nitkitf. 

Gm. 


.0()    —.30 


Glonoix  ( Nitroglyeerin), 

Gill.  .0005— .001 
Spiritus  Gloxoini, 

Gm.  .O:]    —.10 
Sodium  Nitrite,  . 

Gm.  .06    —.20 

Classified  as : 
Vaso-dilator.s. 
Circulatory  .stimulants. 

Physiologic  action  : 

While  the  action  of  the 
several  drug.s  of  this  group 
is  very  similar,  Amyl  Ni- 
trite (by  inhalation)  has  the 
most  rapid  and  transient 
effect,  Glonoin  is  most  powerful  and  Sodium 
Nitrite  has  the  most  permanent  effect. 

NervouH  Sj/stern. 
Brain.    No  direct  influence  upon  cerebrum. 
Medulla.    Depresses  vagus  centre. 

Muscular    SijHtein.      Paralyzes     the    muscular   coats    of 

arterioles  and  probably  of  veins. 
Circulation.     Causes  a  decided   fall  in   arterial  pressure 
with  acceleration  of  pulse. 
Heart.    Any  direct  action  upon  the   heart  js  doubtful. 
The    acceleration    is   mainly   due   to    depression    of 
vagus  centre. 
Capillary  area.    Dilates  arterioles,  thereby  increasing  the 

volume  and  efficiency  of  the  capillary  ciniulation. 
The   influence  upon  arterial  pressure  and  pulse  rate  is 
shown  by  tlie  following  sphygmographic  pulse  tracings: 

Normal  pulse  tracing.     Rate  84. 

AJWUUUUUl 

TJie  same  after  taking  Nitroglycerin.    Rate  90. 


^<r(vieP/(XH9. 


NOTK.— Thn  blood-ohanKCK  pro<liifc(|  in  fiiilinalK  by  Amyl  Nitrite  arc  not  soon  In  man  under 
therapeutic  donate. 


NUX  VOMICA— Strychnine. 

[For  general  explanation  of  diagrams  see  page  one.] 

NUX  VOMICA. 

The  seeds  of  Stryehnos  Nux  V. 
Tlie  allcaloid  Strychnine  represents 
the  drug  fully. 

Classified  as : 

Bitter  tonic. 
Cardiac  stimulant. 
Nerve  tonic. 
Excito-motor. 

Physiologic  action  : 

Digestive  tract.  Stimulates 
secretion  of  gastric  juice 
and  motility  of  stomach. 
Other  digestive  secre- 
tions may  be  increased. 
Nervotis  Sijsteia. 

Cerebrum.  Noeflfect  upon  cortex.  Conscious- 
ness not  influenced.  Special  senses 
rendered  more  acute. 

IHedulla.  Stimulates  respiratory  and  vaso- 
motor centres.  Influence  upon  vagus 
centre  is  uncertain. 

Spinal  cord.    Increases    re- 
flex   irritability   of    the 
cord  in  its  whole  extent. 
Circulation.     Arterial   pres- 
sure increased. 

Heart.     It  is  believed  to  stimulate  either  heart  muscle 
or  cardiac  ganglia  or  both. 

Capillary  area.     Arterioles  are   contracted   by  its  action 
upon  vaso-motor  centres  of  medulla  and  cord. 
Excretion.     Eliminated  by  the  kidneys,  appearing  soon 
after    absorption,    partly    unchanged    and      partly 
changed. 

Contraction  of  renal  vessels  may  hinder  its  elimina- 
tion. 


23 


OFFICIAL  preparations: 

Extrnclum  Nucis   VomicfB. Gm.  .0075—  .06 

Extr actum  NuciH  VomicfB  Fluidum. .  .Qinx.  .00    —  .25 

Tinctura  Nucin  VomicfP Gm.  .30    — 2. 

Slr/fchniwr  Sulphan Gm.  .001  —  .006 


lWl/»cP/«XH9. 


OPIUM  ALKALOIDS. 
[For  general  explanation  of  diagrams  see  page  one.] 


MORPHINE. 

In    form  of  sulphate,  acetate 

or   HYDROCHLOBATE. 

Gni.  .008— .015. 

Classified  as : 

Anodjnie.  Narcotic. 

IMi^'siologic  action : 

The  action   of  morphine  is  essen- 
tially that  of  a  central   nerve   depressant, 
the  local  action  of  the  drug'  wherever  ap- 
plied being  almost  7iiL 
Nervous  Si/stem. 
Brain.    Depresses  cerebrum  especially  in  its  higher 

intellectual  functions. 
Medulla.     Depresses  respiratory  centre. 
Spinal  cord.     Does  not  perceptibly  intluence  the  cord. 

XOTE.— In  lower  animals  morphine  is  a  stimulant  to  the  spinal 
cord,  but  in  man  niarked  depression  of  the  highly  developed 
brain  prevents  any  manifestation  of  spinal  stimulation. 

Nerves.    The  peripheral   nerves  are    not  affected  by 
ordinary  doses. 
yfusr-ular  Si/Htem.    Not    affected   by 

ordinary  doses. 
Circulation.     Not    much    influenced 
by  ordinary  doses. 
Heart.    Opinions    differ.      Any    in- 
fluence of  a  moderate  dose  must 
be  slight  and  probably  indirect. 
Large    doses    slow  the  heart  by 
stimulating  inhibition. 
Capillary  area.    Not  much  influenced 
except    cutaneous   area  of  head 
and  neck  may  show  dilation. 

Jlenpiration.     Depressed  to  a  <legree 
corresponding  with  size  of  dose. 

/'^>/^.     I'upils    contracted    by   central 
nerve  influence. Ar*'*^-»^/<'^^—^ 

hif/f  ntirc  Si/xtriil. 

Stomach.     Secretion  and  motility  lessened. 

intestines.     I^eristalsis  is  greatly  diminished. 
ELbaiiiutUni.     Secretions  generally  are  din)inisiied  (except 
the  perspiration.     The  drug  is  partly  changed  in  tiie 
system,   but  the   greater    j)art    is   eliminated    by  the 
gastro-intestiruil  tract. 

CODKF.N'K.     licss  powerful  ;in(l  cjepre.ssiiig  tlian  morphiiH 

IMlftleim.'uil. 

HKIIOINK.     Has  a    more;   depressant    r-(I'iM!t  up')ri    II 
rii'Tphine  or  (todcine. 


?16%VAS. 


^<UicP/<XH9. 


After-etre 

(ii 

respiratory   c 

(! 


cts  are  less 
n.  .015— .12. 
entre  than 
ni.  .0()5-.0l 


26 


ETHER. 


[For  general  explanation  of  diagrams  see  page  one.] 


?\e%M$. 


fSHviaPbxHS. 


AETHER. 

Classif 

Stimulant. 

Anaesthetic. 

The  action  of  tliese  two  substances  is  very 

degree  in  whicli  they  affect  various  orgai 

Physiolog 
Ether,  in  tlie  concentrated  form  in 
which  it  is  administered,  is  more  irritat- 
ing than  cliloroform,  therefore  the  pri- 
mary reflex  stimulation  and  the  later  ex- 
citement are  mucii  more  pronounced. 

It  may  cause  danger  by  paralysis  of 
respiration,  but  the  heart  is  so  slightly 
depressed  that  recovery  may  usually  be 
secured. 

Locally  applied  the  drug  is  an  irritant. 

Nervous  System. 
Brain.    Depresses  cerebrum,  abolishing 

all  of  its  functions. 
Medulla.    Of  the  whole  central  nervous 

system  the  medulla  is  affected  last. 

In  dangerous  narcosis  the  respiratory 

and  vaso-motor  centres  are  paralyzed. 
Spinal  cord.    Abolishes  all  functions,  the 

sensory   side  being  paralyzed  before 

the  motor. 

Circulation, 

Not  much  altered  from  the  normal  un- 
til anaesthesia  is  profound,  when  arterial 
pressure  is  diminished. 

Heart.  Early  may  show  reflex  stimula- 
tion. Later  not  much  affected  unless 
administration  is  prolonged,  when 
some  depression  may  occur. 
Capillary  area.  Some  dilation  of  cutan- 
eous arterioles  usually  occurs,  with 
flushing  of  face. 

Ejje,    Early  the  pupils  are  dilated.    Dur- 
ing complete  anaesthesia  they  are  con- 
tracted. With  dangerous  paralysis  they  1 
dilate.  | 

Respiration.     May  be  irregular  or  inter-| 
rupted  during  partial  anaesthesia.    Dur- 1 
ing    full  anaesthesia  it  is    regular  and  i 
normal  as  during  sleep.      In  dangerous 
narcosis  it  fails    through    paralysis    o1 
the  respiratory  centre. 

Temperature  is  reduced  during  anaesthesis 

Metabolism.  Influence  is  usually  slight 
and  transient.  The  drug  is  eliminated 
chiefly  by  the  lungs. 


CHLOROFORM.  27 

[Koi"  gcnci'al  explanation  of  diagrams  sec  pa^e  one.] 


as 


CHLDROFDRMUM. 


Anodyne. 
Anjvsthetic. 


lilar,  the  main  difl'erences  being  in  the 

action  : 

Chloroform  is  pleasanter  to  inhale,  bnt 
inuch  more  depressant  to  nerve-centres 
and  heart. 

According  to  Cushny  it  is  3  to  3>^  times  as 
depressant  to  the  central  nervous  system,  and 
36  to  48  times  as  depressant  to  the  heart,  as  is 
ether. 

It  usually  causes  death  by  paralysis  of 
respiration, the  heart  continuing  to  beat, 
though  so  <^reatly  depressed  as  to  pre- 
veut  tecovery  in  many  cases. 

Locally  apj>lied  the  drug  is  an  irritant. 

Nervous  S'l/stcm. 
Brain.    Depresses  cerebrum,  abolishing 

all  of  its  functions. 
Medulla.    Of  tlie  whole  central  nervous  system  the  medulla 

is  attected  last.      In  dangerous  narcosis  the  respiratory 

and  vaso-motor  centres  are  paralyzed. 

Spinal  cord.    Abolishes  all  functions,  the  sensory  side  being 
paralyzed  before  the  motor. 

Circulation. 

Much  more  depressed  ))y  chloroform  than  by  ether.  Arte- 
rial pressure  decidedly  diminished,  probably  by  both  cardiac 
and  vaso-motor  depression. 

Heart.  Depresses  the  heart  muscle  or  its  ganglia.  By 
prolonged  action  may  cause  fatty  degeneration. 


Capillary  area, 
sion. 


Arterioles   relaxed   by   vaso-motor  depres- 


Si/e.  E'lrly  the  pupils  arc;  dilated.  During  complete  an- 
aistheHJa  they  are  (!ontracted.  With  dangerous  i)aritlysis 
they  tlilate. 

lieMpirafion.  During  partial  aujcsthesia  it  is  lessdistnrbed 
in  a  reflf!X  way  than  with  etlnsr.  During  full  anu'stliesia 
it  is  regular  and  normal  as  during  sleep.  In  dangerous 
narcosis  it  fails  through  paralysis  of  the  resi)iratory 
centre. 

Tcrnprrniurc  is  reduced  during  aniesthesia. 

MeffiholiHm.  Destruction  of  proteids  is  increased  with  less 
perfect  oxidation.  Fatty  df^generation  of  heart,  liver 
and  kidneys  irniy  occur.  The  drug  is  eliminated  chielly 
by  tin-  Iniig.s,  i)Mt  it  has  l)e«;n  found  in  (he  urine. 


ficlviePfcxHS. 


28 


30 


32 


34 


36 


38 


40 


42 


44 


4G 


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